What is Depression?

What is depression? Many people don’t realize they have depression, because depression can take many forms.

A lot of my patients are surprised when I suggest they have depression.  “But I don’t stay in bed all day and I can function, and I’m not sad ALL the time” they tell me.  Lots of people have a stereotypical image of what depression is: someone who mopes around the house, who can’t function, who cries all the time.  Yet, depression manifests itself in many different ways in adults (children manifest depression differently such as acting out or being withdrawn), there are many causes of depression, and many types of depression.  Below are some of the most common.

Situational Depression

Essentially, our mood is regulated by chemicals in our brain, mostly a neurotransmitter called Serotonin.  We all need to have a certain amount of Serotonin to feel good, and under normal circumstances our body produces it.  However, just like other body functions may be affected when we are under stress, so is Serotonin production.

Whether the stressor is good (like a wedding or a new job) or bad (like a divorce or financial problems) it affects the steady flow of serotonin in our brain.  And over time, we can become depressed and experience some of the symptoms associated with depression.

Sometimes a situational depression will resolve itself on its own after the stressor (i.e. difficult situation) has past, but often it doesn’t.  That’s because the body has been stressed too much or for too long and it can not kick start good levels of serotonin.  It’s almost like a car battery going dead and needing a jump start.  The battery still has power in it, but it can’t get started back up on its own.

Depression with a Biological or Medical Cause

 Hormonal Shifts, Menopause, and PMDD (Pre-Menstrual Dysphoric Disorder):

Hormones are a bitch, and they can certainly make you act like a bitch (hey let’s get real, we all know that!).  Hormonal shifts are most common in women, but can occur in men too (such as with low testosterone).  These types of depressions are best evaluated by a psychotherapist working in conjunction with a physician.  This way, any underlying medical causes can be addressed, and psychotherapy can help patients learn news way of coping with the symptoms cause by hormonal imbalance.

Medication-induced Depression:

Some medications (like some birth control pills) can lead to depression.  This is another case where a combined approach of a psychotherapist and physician working in tandem is useful.

More Depression Types in Part  2 of this post: Types of Depression – Part 2.